Organization
DYNACARE NORTHWEST, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY T WILLIAMS (VP)
(800) 222-7566
Entity
Organization
Contact information
Practice address
22707 SE 29TH ST, BLDG C, SAMMAMISH, WA 98075-9532
(425) 455-2845
Mailing address
PO BOX 2240, BURLINGTON, NC 27216-2240
(800) 222-7566
(336) 436-1048
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50D1022190
CLIA
WA
05
—
7126865
—
WA
Enumeration date
01/04/2006
Last updated
11/04/2015
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